Highlights
- •Most infective endocarditis in solid organ transplantation patients are nosocomial
- •Over 70% are health care-related.
- •Half have previously normal heart valves
- •Almost 60% are due to Staphylococcus spp. infections.
- •Mortality seems to be similar to non- solid organ transplantation counterparts
Abstract
Background
Solid organ transplantation (SOT) implies immunosuppression and frequent health care
contact. Our aim was to compare the characteristics of patients with infective endocarditis
(IE) and SOT against those without SOT.
Methods
We used data from the Spanish Collaboration on Endocarditis during the period 2008-2018.
Results
We identified 4794 cases of IE, 85 (1.8%) in SOT (56 kidney, 18 liver, 8 heart, 3
lung). Thirteen patients with other transplantation types (bone marrow, hematopoietic
precursors, and cornea) were excluded from the analysis. Compared with patients without
SOT, patients with SOT had lower median age (61 vs. 69 years, p<0.001), more comorbidities
(mean age-adjusted Charlson index 5.7±2.9 vs. 4.9±2.9, p=0.004), a lower prevalence
of native valvular heart disease (29.4 vs. 45.4%, p=0.003), more in-hospital and healthcare-related
IE (70.5% vs. 36.3%, p<0.001) and staphylococcal etiology (57.7% vs. 39.7%, p=0.001).
Patients with SOT had more frequent kidney function worsening (47.1% vs. 34.6%, p=0.02),
septic shock (25.9% vs. 12.1 %, p<0.001), sepsis (27.1% vs. 17.2%, p=0.02), and less
surgery indication (54.1% vs 66.3%, p=0.02) and surgery (32.9% vs. 46.3%, p=0.01)
than patients without SOT. There were no significant differences in mortality: inhospital
(30.6% SOT vs. 25.6% without SOT, p=0.31), 1-year (38.8% SOT vs. 31.9% without SOT,
p=0.18).
Conclusions
Most IE in SOT recipients are nosocomial and over 70% are health care-related. Half
have previously normal heart valves and almost 60% are due to Staphylococcus spp.
infections. Mortality seems to be similar to non-SOT counterparts.
Keywords
Abbreviations:
GAMES (Spanish Collaboration on Endocarditis — Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España), IE (Infective endocarditis), SOT (Solid organ transplantation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 05, 2021
Accepted:
February 17,
2021
Received in revised form:
January 1,
2021
Received:
October 30,
2020
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
